PREVENTIVE MEASURES

1. Pre – exercise hypoglycemia :

 Moniter blood glucose level to ensure the
safety during exercise.
 Prior information should be taken about
insulin and oral medication.
 Determine the duration and intensity of
the session accordingly.
Blood Intensity Duration of Carb
pressure of exercise exercise supplementation
<100 low short 5-10gm
mg/dl
<100 moderate moderate 25-45gm
mg/dl
<100 high long 45gm or more
mg/dl
>100 low short Not needed
mg/dl
100- moderate moderate 15-30gm
180mg/dl
100- high Long term 30-45gm
180mg/dl
2. Pre – hyperglycemia:
 If pre – exercise blood glucose is
>300mg/dl, and ketone bodies are
present (moderate-high), then exercise
session is postponed until sugar level is
under control.
 If pre-exercise blood glucose level is
>300mg/dl, ketone bodies are absent, it
is safe to do exercise with proper
hydration.
 Medication should be considered (short
acting or long acting) before exercise
prescription.
3. Post – exercise hypoglycemia :
 As post exercise muscle glycogen uptake
increases, hypoglycemia(<70mm/dl) is
common.
 Periodic monitoring during exercise
should be done.
 Carbohydrate supplementation is needed.
 Mandatory for beginners.
4. Post – exercise hyperglycemia:
 In poorly controlled diabetes, insulin levels are
often low, which leads to increase in
counterregulatory hormones with exercise.
 Hence glucose production increases in
following way –
 Increase glucose production by liver,
 Decrese uptake of glycogen by
exercising muscle,
 Increase FFA release by adipose
tissue.
 Type 1 diabetes has high incidence rate.